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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 5 - Infections 
Notes:

For full details on UKHSA guidance for managing common infections with local amendments please see:

BLMK Primary Care Antimicrobial Guidelines hosted via: https://blmkantibioticspubliclive.azurewebsites.net/

Secondary care antimicrobial guidelines:

Bedfordshire Hospitals Foundation Trust: Antimicrobial guidelines are hosted on:  EOLAS Medical App. 
05.03.01 HIV infection
All prescribing for HIV patients should be in line with current BHIVA guidelines
05.03.01 Nucleoside reverse transcriptase inhibitors
05.03.01 Protease inhibitors
05.03.01 Non-nucleoside reverse transcriptase inhibitors
05.03.01 Other antiretrovirals

Dolutegravir

RED
Restricted Drug Restricted
50mg Film Coated Tablets

Restricted - must be initiated by GUM & Microbiology consultants only

Switch to raltegravir where possible
BNF BNFc SPC
MHRA Drug Safety Update (October 2020): updated advice on increased risk of neural tube defects MHRA DSU (June 18): Dolutegravir (Tivicay▼, Triumeq▼, Juluca▼): signal of increased risk of neural tube defects; do not prescribe to women seeking to become pregnant

Dolutegravir & lamivudine (Dovato®)

RED
Restricted Drug Restricted

Dolutegravir sodium equivalent to 50 mg dolutegravir and 300 mg lamivudine.

Restricted - prescribing by HIV Consultants only in accordance with BHIVA guidelines and NHSE Clinical Commissioning policy.

BNF BNFc SPC

Dolutegravir & rilpivirine (Juluca®)

RED
Restricted Drug Restricted

Dolutegravir sodium equivalent to 50 mg dolutegravir and 25mg rilpivirine.

Restricted - prescribing by HIV Consultants only in accordance with BHIVA guidelines and NHSE Clinical Commissioning policy.

BNF BNFc SPC

Dolutegravir, abacavir & lamivudine (Triumeq®)

RED
Restricted Drug Restricted
Dolutegravir 50mg/Abacavir 600mg/Lamivudine 300mg Flim Coated Tablets

Restricted - prescribing by HIV Consultants only in accordance with BHIVA guidelines and NHSE Clinical Commissioning policy.

Switch to raltegravir PLUS generic abacavir / lamivudine where possible
BNF BNFc SPC
MHRA DSU (June 18): Dolutegravir (Tivicay▼, Triumeq▼, Juluca▼): signal of increased risk of neural tube defects; do not prescribe to women seeking to become pregnant

Maraviroc

RED
Restricted Drug Restricted
150mg & 300mg Film Coated Tablets
Restricted - must be initiated by HIV consultants only

BNF BNFc SPC

Raltegravir (Isentress ®)

RED
Restricted Drug Restricted

25mg chewable Tablets
400mg Film Coated Tablets

600mg Film Coated Tablets
Restricted - must be initiated by HIV consultants only

BNF BNFc SPC
Department Of Health (April 2015) - EAGA guidance on HIV post-exposure prophylaxis
05.03.01 Pharmacokinetic enhancers of antiretrovirals
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.